[Valvular stenosis: treatment by percutaneous dilatation]

For more than a decade, cardiologists have now used procedures for treating valvular stenosis. The most widely used, percutaneous mitral commissurotomy, is performed through the transseptal pathway, usually with the Inoue balloon. Subsequently, the valvular surface doubles and the incidence of serious complications is low in experienced teams. Evaluation of ten years of experience shows that long-term results are good if the dilatation was efficient immediately. In the other cases, surgery must be performed. Percutaneous mitral commissurotomy is the preferred solution in young patients with good valvular anatomy; in others, its indication should be discussed on a case-by-case basis. It is contraindicated in the presence of thrombosis of the left auricle or severe valvular calcification. The results of aortic valvuloplasty for calcified stenosis in the elderly subject are poor, with elevated mortality and morbidity. Valvuloplasty little affects the natural history of a tight aortic stenosis but can offer transitory functional improvement for several months. Its indications are rare.